Individual
JOHN MILLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1550 3 MILE RD NW, WALKER, MI 49544-8251
(616) 785-3883
Mailing address
1550 3 MILE RD NW, WALKER, MI 49544-8251
(616) 785-3883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301082500
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0804114922
BCBS
MI
01
—
0M80080
MEDICARE
MI
01
—
1598712390
GROUP NPI
MI
01
—
1649287517
GROUP NPI
MI
05
—
4779268
—
MI
05
—
4779277
—
MI
05
—
4779286
—
MI
05
—
4779295
—
MI
05
—
4779301
—
MI
Enumeration date
05/16/2006
Last updated
05/13/2011
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